855-P: Utilization of Continuous Glucose Monitoring (CGM) and Its Impact on the Care of Veterans

Abstract

Background: Continuous Glucose Monitoring (CGM) is useful in the management of patients on insulin therapy. In late 2017 a diagnostic CGM clinic was implemented in our VA hospital to aid in the management of diabetes. Our aim is to measure the impact of CGM technology in the veteran population. Methods: Retrospective chart review of all the patients who received a diagnostic CGM (Libre Pro) between January 2018 through October 2019. Patients underwent a diagnostic CGM (blind) if they were on insulin therapy or had an A1c > 7%. We evaluated: glycemic control and travel distance to the VA hospital. A total of 208 patients with diabetes were included in the study (males 91%). The most common diagnosis was T2D 86%, followed by T1D 14%. The mean A1c was 8.4% +/- 1.8. CGM data was examined by an endocrinologist and necessary medication adjustments were recommended. Results: Patients wore the CGM on an average of 10.3 days +/- 4.6, the glucose average was 174.7 +/- 56. In 20 patients, the sensor did not recorded data. The time in range (70-180 mg/dL) was 45% +/- 26, the time above the range was 26 +/- 27. Hypoglycemia (<70 mg/dL) was seen more than 5% of the CGM wore in 32% of patients. In 65% of patient, the CGM prompted a change in treatment regimen. Because CGM results and physician recommendations were communicated via telephone, patients saved an average travel distance of 60 miles SD 38.5, or roughly 120 of roundtrip travel time. Of the patients whose insulin regimen changed after CGM placement, the average HbA1c decreased from 8.2% to 7.5% (p < 0.05). 100% of participants surveyed rated their satisfaction at highest and reported they would wear the CGM device again. Conclusion: A diagnostic CGM clinic significantly improved glycemic control and reduced travel time in the studied veteran population. The diagnostic CGM was well accepted. A rational use of CGM technology may therefore lead to improved diabetes management. Disclosure G. Barsamyan: None. A. da Silva: None. L. Whyte: None. M. Amole: None. H. Ghayee: None. J.A. Leey: None.